Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Suggested Citation:"Report Contents." Institute of Medicine. 2000. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: The National Academies Press. doi: 10.17226/9824.

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

S1
Executive Summary
cientists have had a long-standing fascination with
the complexities of the process of human develop-
ment. Parents have always been captivated by the
rapid growth and development that characterize the earliest years of their
childrenâs lives. Professional service providers continue to search for new
knowledge to inform their work. Consequently, one of the distinctive fea-
tures of the science of early childhood development is the extent to which it
evolves under the anxious and eager eyes of millions of families, policy
makers, and service providers who seek authoritative guidance as they
address the challenges of promoting the health and well-being of young
children.
PUTTING THE STUDY IN CONTEXT
Two profound changes over the past several decades have coincided to
produce a dramatically altered landscape for early childhood policy, service
delivery, and childrearing in the United States. First, an explosion of re-
search in the neurobiological, behavioral, and social sciences has led to
major advances in understanding the conditions that influence whether
children get off to a promising or a worrisome start in life. These scientific
gains have generated a much deeper appreciation of: (1) the importance of
early life experiences, as well as the inseparable and highly interactive in-
fluences of genetics and environment, on the development of the brain and
the unfolding of human behavior; (2) the central role of early relationships

2 FROM NEURONS TO NEIGHBORHOODS
as a source of either support and adaptation or risk and dysfunction; (3) the
powerful capabilities, complex emotions, and essential social skills that
develop during the earliest years of life, and (4) the capacity to increase the
odds of favorable developmental outcomes through planned interventions.
Second, the capacity to use this knowledge constructively has been
constrained by a number of dramatic transformations in the social and
economic circumstances under which families with young children are liv-
ing in the United States: (1) marked changes in the nature, schedule, and
amount of work engaged in by parents of young children and greater
difficulty balancing workplace and family responsibilities for parents at all
income levels; (2) continuing high levels of economic hardship among fami-
lies, despite overall increases in maternal education, increased rates of par-
ent employment, and a strong economy; (3) increasing cultural diversity
and the persistence of significant racial and ethnic disparities in health and
developmental outcomes; 4) growing numbers of young children spending
considerable time in child care settings of highly variable quality, starting in
infancy; and (5) greater awareness of the negative effects of stress on young
children, particularly as a result of serious family problems and adverse
community conditions that are detrimental to child well-being. While any
given child may be affected by only one or two of these changes, their
cumulative effects on the 24 million infants, toddlers, and preschoolers who
are now growing up in the United States warrant dedicated attention and
thoughtful response.
This convergence of advancing knowledge and changing circumstances
calls for a fundamental reexamination of the nationâs responses to the needs
of young children and their families, many of which were formulated sev-
eral decades ago and revised only incrementally since then. It demands that
scientists, policy makers, business and community leaders, practitioners,
and parents work together to identify and sustain policies and practices that
are effective, generate new strategies to replace those that are not achieving
their objectives, and consider new approaches to address new goals as
needed. It is the strong conviction of this committee that the nation has not
capitalized sufficiently on the knowledge that has been gained from nearly
half a century of considerable public investment in research on children
from birth to age 5. In many respects, we have barely begun to use our
growing research capabilities to help children and families negotiate the
changing demands and possibilities of life in the 21st century.
THE COMMITTEEâS CHARGE
The Committee on Integrating the Science of Early Childhood Develop-
ment was established by the Board on Children, Youth, and Families of the
National Research Council and the Institute of Medicine to update scien-

EXECUTIVE SUMMARY 3
tific knowledge about the nature of early development and the role of early
experiences, to disentangle such knowledge from erroneous popular beliefs
or misunderstandings, and to discuss the implications of this knowledge
base for early childhood policy, practice, professional development, and
research.
The body of research that the committee reviewed is extensive, multi-
disciplinary, and more complex than current discourse would lead one to
believe. It covers the period from before birth until the first day of kinder-
garten. It includes efforts to understand how early experience affects all
aspects of developmentâfrom the neural circuitry of the maturing brain, to
the expanding network of a childâs social relationships, to both the endur-
ing and the changing cultural values of the society in which parents raise
children. It includes efforts to understand the typical trajectories of early
childhood, as well as the atypical developmental pathways that characterize
the adaptations of children with disabilities.
The committeeâs review of this evidence addresses two complementary
agendas. The first is focused on the future and asks: How can society use
knowledge about early childhood development to maximize the nationâs
human capital and ensure the ongoing vitality of its democratic institu-
tions? The second is focused on the present and asks: How can the nation
use knowledge to nurture, protect, and ensure the health and well-being of
all young children as an important objective in its own right, regardless of
whether measurable returns can be documented in the future? The first
agenda speaks to societyâs economic, political, and social interests. The
second speaks to its ethical and moral values. The committee is clear in our
responsibility to speak to both.
CORE CONCEPTS OF DEVELOPMENT
As the knowledge generated by interdisciplinary developmental science
has evolved and been integrated with lessons from program evaluation and
professional experience, a number of core concepts, which are elaborated in
the report, have come to frame understanding of the nature of early human
development.
1. Human development is shaped by a dynamic and continuous inter-
action between biology and experience.
2. Culture influences every aspect of human development and is re-
flected in childrearing beliefs and practices designed to promote healthy
adaptation.
3. The growth of self-regulation is a cornerstone of early childhood
development that cuts across all domains of behavior.

4 FROM NEURONS TO NEIGHBORHOODS
4. Children are active participants in their own development, reflecting
the intrinsic human drive to explore and master oneâs environment.
5. Human relationships, and the effects of relationships on relation-
ships, are the building blocks of healthy development.
6. The broad range of individual differences among young children
often makes it difficult to distinguish normal variations and maturational
delays from transient disorders and persistent impairments.
7. The development of children unfolds along individual pathways
whose trajectories are characterized by continuities and discontinuities, as
well as by a series of significant transitions.
8. Human development is shaped by the ongoing interplay among
sources of vulnerability and sources of resilience.
9. The timing of early experiences can matter, but, more often than not,
the developing child remains vulnerable to risks and open to protective
influences throughout the early years of life and into adulthood.
10. The course of development can be altered in early childhood by
effective interventions that change the balance between risk and protec-
tion, thereby shifting the odds in favor of more adaptive outcomes.
POLICY AND PRACTICE
The committeeâs conclusions and recommendations are derived from a
rich and extensive knowledge base and are firmly grounded in the following
four overarching themes:
â¢ All children are born wired for feelings and ready to learn.
â¢ Early environments matter and nurturing relationships are essential.
â¢ Society is changing and the needs of young children are not being
addressed.
â¢ Interactions among early childhood science, policy, and practice are
problematic and demand dramatic rethinking.
All Children Are Born Wired for Feelings and Ready to Learn
From the time of conception to the first day of kindergarten, develop-
ment proceeds at a pace exceeding that of any subsequent stage of life.
Efforts to understand this process have revealed the myriad and remarkable
accomplishments of the early childhood period, as well as the serious prob-
lems that confront some young children and their families long before
school entry. A fundamental paradox exists and is unavoidable: develop-
ment in the early years is both highly robust and highly vulnerable. Al-
though there have been long-standing debates about how much the early
years really matter in the larger scheme of lifelong development, our con-

EXECUTIVE SUMMARY 5
clusion is unequivocal: What happens during the first months and years of
life matters a lot, not because this period of development provides an
indelible blueprint for adult well-being, but because it sets either a sturdy or
fragile stage for what follows.
Conclusions
â¢ From birth to age 5, children rapidly develop foundational capabili-
ties on which subsequent development builds. In addition to their remark-
able linguistic and cognitive gains, they exhibit dramatic progress in their
emotional, social, regulatory, and moral capacities. All of these critical
dimensions of early development are intertwined, and each requires focused
attention.
â¢ Striking disparities in what children know and can do are evident
well before they enter kindergarten. These differences are strongly associ-
ated with social and economic circumstances, and they are predictive of
subsequent academic performance. Redressing these disparities is critical,
both for the children whose life opportunities are at stake and for a society
whose goals demand that children be prepared to begin school, achieve
academic success, and ultimately sustain economic independence and en-
gage constructively with others as adult citizens.
â¢ Early child development can be seriously compromised by social,
regulatory, and emotional impairments. Indeed, young children are capable
of deep and lasting sadness, grief, and disorganization in response to trauma,
loss, and early personal rejection. Given the substantial short- and long-
term risks that accompany early mental health impairments, the incapacity
of many early childhood programs to address these concerns and the severe
shortage of early childhood professionals with mental health expertise are
urgent problems.
Recommendations
â¢ Recommendation 1 â Resources on a par with those focused on
literacy and numerical skills should be devoted to translating the knowl-
edge base on young childrenâs emotional, regulatory, and social develop-
ment into effective strategies for fostering: (1) the development of curiosity,
self-direction, and persistence in learning situations; (2) the ability to coop-
erate, demonstrate caring, and resolve conflict with peers; and (3) the ca-
pacity to experience the enhanced motivation associated with feeling com-
petent and loved. Such strategies and their widespread diffusion into the
early childhood field must encompass young children both with and with-

6 FROM NEURONS TO NEIGHBORHOODS
out special needs. Successful action on this recommendation will require
the long-term, collaborative investment of government, professional orga-
nizations, private philanthropy,and voluntary associations.
â¢ Recommendation 2 â School readiness initiatives should be judged
not only on the basis of their effectiveness in improving the performance of
the children they reach, but also on the extent to which they make progress
in reducing the significant disparities that are observed at school entry in
the skills of young children with differing backgrounds.
â¢ Recommendation 3 â Substantial new investments should be made
to address the nationâs seriously inadequate capacity for addressing young
childrenâs mental health needs. Expanded opportunities for professional
training, as recently called for by the Surgeon General, and incentives for
individuals with pertinent expertise to work in settings with young children
are essential first steps toward more effective screening, early detection,
treatment, and ultimate prevention of serious childhood mental health prob-
lems.
Early Environments Matter and Nurturing Relationships Are Essential
The scientific evidence on the significant developmental impacts of
early experiences, caregiving relationships, and environmental threats is
incontrovertible. Virtually every aspect of early human development, from
the brainâs evolving circuitry to the childâs capacity for empathy, is affected
by the environments and experiences that are encountered in a cumulative
fashion, beginning early in the prenatal period and extending throughout
the early childhood years. The science of early development is also clear
about the specific importance of parenting and of regular caregiving rela-
tionships more generally. The question today is not whether early experi-
ence matters, but rather how early experiences shape individual develop-
ment and contribute to childrenâs continued movement along positive
pathways.
Conclusions
â¢ The long-standing debate about the importance of nature versus
nurture, considered as independent influences, is overly simplistic and sci-
entifically obsolete. Scientists have shifted their focus to take account of the
fact that genetic and environmental influences work together in dynamic
ways over the course of development. At any time, both are sources of
human potential and growth as well as risk and dysfunction. Both geneti-
cally determined characteristics and those that are highly affected by expe-
rience are open to intervention. The most important questions now con-
cern how environments influence the expression of genes and how genetic

EXECUTIVE SUMMARY 7
makeup, combined with childrenâs previous experiences, affects their on-
going interactions with their environments during the early years and
beyond.
â¢ Parents and other regular caregivers in childrenâs lives are âactive
ingredientsâ of environmental influence during the early childhood period.
Children grow and thrive in the context of close and dependable relation-
ships that provide love and nurturance, security, responsive interaction,
and encouragement for exploration. Without at least one such relationship,
development is disrupted and the consequences can be severe and long-
lasting. If provided or restored, however, a sensitive caregiving relationship
can foster remarkable recovery.
â¢ Childrenâs early development depends on the health and well-being
of their parents. Yet the daily experiences of a significant number of young
children are burdened by untreated mental health problems in their fami-
lies, recurrent exposure to family violence, and the psychological fallout
from living in a demoralized and violent neighborhood. Circumstances
characterized by multiple, interrelated, and cumulative risk factors impose
particularly heavy developmental burdens during early childhood and are
the most likely to incur substantial costs to both the individual and society
in the future.
â¢ The time is long overdue for society to recognize the significance of
out-of-home relationships for young children, to esteem those who care for
them when their parents are not available, and to compensate them ad-
equately as a means of supporting stability and quality in these relation-
ships for all children, regardless of their familyâs income and irrespective of
their developmental needs.
â¢ Early experiences clearly affect the development of the brain. Yet the
recent focus on âzero to threeâ as a critical or particularly sensitive period
is highly problematic, not because this isnât an important period for the
developing brain, but simply because the disproportionate attention to the
period from birth to 3 years begins too late and ends too soon.
â¢ Abundant evidence from the behavioral and the neurobiological sci-
ences has documented a wide range of environmental threats to the devel-
oping central nervous system. These include poor nutrition, specific infec-
tions, environmental toxins, and drug exposures, beginning early in the
prenatal period, as well as chronic stress stemming from abuse or neglect
throughout the early childhood years and beyond.

8 FROM NEURONS TO NEIGHBORHOODS
Recommendations
â¢ Recommendation 4 â Decision makers at all levels of government,
as well as leaders from the business community, should ensure that better
public and private policies provide parents with viable choices about how
to allocate responsibility for child care during the early years of their
childrenâs lives. During infancy, there is a pressing need to strike a better
balance between options that support parents to care for their infants at
home and those that provide affordable, quality child care that enables
them to work or go to school. This calls for expanding coverage of the
Family and Medical Leave Act to all working parents, pursuing the com-
plex issue of income protection, lengthening the exemption period before
states require parents of infants to work as part of welfare reform, and
enhancing parentsâ opportunities to choose from among a range of child
care settings that offer the stable, sensitive, and linguistically rich caregiving
that fosters positive early childhood development.
â¢ Recommendation 5 â Environmental protection, reproductive
health services, and early intervention efforts should be substantially ex-
panded to reduce documented risks that arise from harmful prenatal and
early postnatal neurotoxic exposures, as well as from seriously disrupted
early relationships due to chronic mental health problems, substance abuse,
and violence in families. The magnitude of these initiatives should be com-
parable to the attention and resources that have been dedicated to crime
prevention, smoking cessation, and the reduction of teen pregnancy. They
will require the participation of multiple societal sectors (e.g., private, pub-
lic, and philanthropic) and the development of multiple strategies.
â¢ Recommendation 6 â The major funding sources for child care and
early childhood education should set aside a dedicated portion of funds to
support initiatives that jointly improve the qualifications and increase the
compensation and benefits routinely provided to childrenâs nonparental
caregivers. These initiatives can be built on the successful experience of the
U.S. Department of Defense.
Society Is Changing and the Needs of Young Children
Are Not Being Addressed
Profound social and economic transformations are posing serious chal-
lenges to the efforts of parents and others to strike a healthy balance be-
tween spending time with their children, securing their economic needs, and
protecting them from the many risks beyond the home that may have an
adverse impact on their health and development.

EXECUTIVE SUMMARY 9
Conclusions
â¢ Changing parental work patterns are transforming family life. Grow-
ing numbers of young children are being raised by working parents whose
earnings are inadequate to lift their families out of poverty, whose work
entails long and nonstandard hours, and whose economic needs require an
early return to work after the birth of a baby. The consequences of the
changing context of parental employment for young children are likely to
hinge on how it affects the parenting they receive and the quality of the
caregiving they experience when they are not with their parents.
â¢ The developmental effects of child care depend on its safety, the
opportunities it provides for nurturing and stable relationships, and its
provision of linguistically and cognitively rich environments. Yet the child
care that is available in the United States today is highly fragmented and
characterized by marked variation in quality, ranging from rich, growth-
promoting experiences to unstimulating, highly unstable, and sometimes
dangerous settings. The burden of poor quality and limited choice rests
most heavily on low-income, working families whose financial resources
are too high to qualify for subsidies yet too low to afford quality care.
â¢ Young children are the poorest members of society and are more
likely to be poor today than they were 25 years ago. Growing up in poverty
greatly increases the probability that a child will be exposed to environ-
ments and experiences that impose significant burdens on his or her well-
being, thereby shifting the odds toward more adverse developmental out-
comes. Poverty during the early childhood period may be more damaging
than poverty experienced at later ages, particularly with respect to eventual
academic attainment. The dual risk of poverty experienced simultaneously
in the family and in the surrounding neighborhood, which affects minority
children to a much greater extent than other children, increases young
childrenâs vulnerability to adverse consequences.
Recommendations
The challenges that arise at the juxtaposition of work, income, and the
care of children reflect some of the most complex problems of contempo-
rary society. Rather than offer recommendations for specific actions, many
of which have been made before and gone unheeded, the committee wishes
to underscore the compelling need for a focused, integrative, and compre-
hensive reassessment of our nationâs child care and income support policies.

10 FROM NEURONS TO NEIGHBORHOODS
â¢ Recommendation 7 â The President should establish a joint federal-
state-local task force charged with reviewing the entire portfolio of public
investments in child care and early education. Its goal should be to develop
a blueprint for locally responsive systems of early care and education for
the coming decade that will ensure the following priorities: (1) that young
childrenâs needs are met through sustained relationships with qualified
caregivers, (2) that the special needs of children with developmental dis-
abilities or chronic health conditions are addressed, and (3) that the settings
in which children spend their time are safe, stimulating, and compatible
with the values and priorities of their families.
â¢ Recommendation 8 â The Presidentâs Council of Economic Advis-
ers and the Congress should assess the nationâs tax, wage, and income
support policies with regard to their adequacy in ensuring that no child
who is supported by the equivalent of a full-time working adult lives in
poverty and that no family suffers from deep and persistent poverty, re-
gardless of employment status. The product of this effort should be a set of
policy alternatives that would move the nation toward achieving these
fundamental goals.
Interactions Among Early Childhood Science, Policy, and Practice Are
Problematic and Demand Dramatic Rethinking
Policies and programs aimed at improving the life chances of young
children come in many varieties. Some are home based and others are
delivered in centers. Some focus on children alone or in groups, and others
work primarily with parents. A variety of services have been designed to
address the needs of young children whose future prospects are threatened
by socioeconomic disadvantages, family disruptions, and diagnosed dis-
abilities. They all share a belief that early childhood development is suscep-
tible to environmental influences and that wise public investments in young
children can increase the odds of favorable developmental outcomes. The
scientific evidence resoundingly supports these premises.
Conclusions
â¢ The overarching question of whether we can intervene successfully
in young childrenâs lives has been answered in the affirmative and should be
put to rest. However, interventions that work are rarely simple, inexpen-
sive, or easy to implement. The critical agenda for early childhood inter-
vention is to advance understanding of what it takes to improve the odds of
positive outcomes for the nationâs most vulnerable young children and to
determine the most cost-effective strategies for achieving well-defined goals.

EXECUTIVE SUMMARY 11
â¢ The scientific knowledge base guiding early childhood policies and
programs is seriously constrained by the relatively limited availability of
systematic and rigorous evaluations of program implementation; gaps in
the documentation of causal relations between specific interventions and
specific outcomes and of the underlying mechanisms of change; and infre-
quent assessments of program costs and benefits.
â¢ Model early childhood programs that deliver carefully designed in-
terventions with well-defined objectives and that include well-designed
evaluations have been shown to influence the developmental trajectories of
children whose life course is threatened by socioeconomic disadvantage,
family disruption, and diagnosed disabilities. Programs that combine child-
focused educational activities with explicit attention to parent-child inter-
action patterns and relationship building appear to have the greatest im-
pacts. In contrast, services that are based on generic family support, often
without a clear delineation of intervention strategies matched directly to
measurable objectives, and that are funded by more modest budgets, ap-
pear to be less effective.
â¢ The elements of early intervention programs that enhance social and
emotional development are just as important as the components that en-
hance linguistic and cognitive competence. Some of the strongest long-term
impacts of successful interventions have been documented in the domains
of social adjustment, such as reductions in criminal behavior.
â¢ The reconciliation of traditional program formats and strategiesâ
many of which emphasize the importance of active parent involvement and
the delivery of services in the home settingâwith the economic and social
realities of contemporary family life is a pressing concern. Particularly ur-
gent is the need to ensure access to these intervention programs for parents
who are employed full-time, those who work nonstandard hours, and those
who are making the transition from public assistance to work.
â¢ Early childhood policies and practices are highly fragmented, with
complex and confusing points of entry that are particularly problematic for
underserved segments of the population and those with special needs. This
lack of an integrative early childhood infrastructure makes it difficult to
advance prevention-oriented initiatives for all children and to coordinate
services for those with complex problems.
â¢ The growing racial, ethnic, linguistic, and cultural diversity of the
early childhood population requires that all early childhood programs and

12 FROM NEURONS TO NEIGHBORHOODS
medical services periodically reassess their appropriateness and effective-
ness for the wide variety of families they are mandated to serve. Poor âtake-
upâ and high rates of program attrition that are common to many early
intervention programs, while not at all restricted to specific racial, ethnic,
or linguistic groups, nonetheless raise serious questions about whether those
who design, implement, and staff early childhood programs fully under-
stand the meaning of âcultural competenceâ in the delivery of health and
human services.
â¢ The general political environment in which research questions are
formulated and investigations are conducted has resulted in a highly prob-
lematic context for early childhood policy and practice. In many circum-
stances, the evaluation of intervention impacts is largely a high-stakes activ-
ity to determine whether policies and programs should receive continued
funding, rather than a more constructive process of continuous knowledge
generation and quality improvement.
â¢As the rapidly evolving science of early child development contin-
ues to grow, its complexity will increase and the distance between the
working knowledge of service providers and the cutting edge of the science
will be staggering. The professional challenges that this raises for the early
childhood field are formidable.
Recommendations
â¢ Recommendation 9 â Agencies and foundations that support evalu-
ation research in early childhood should follow the example set by the
nationâs successful approach to clinical investigation in the biomedical sci-
ences. In this spirit, the goals of program-based research and the evaluation
of services should be to document and ensure full implementation of effec-
tive interventions, and to use evidence of ineffectiveness to stimulate further
experimentation and study.
â¢ Recommendation 10 â The time is long overdue for state and local
decision makers to take bold actions to design and implement coordinated,
functionally effective infrastructures to reduce the long-standing fragmen-
tation of early childhood policies and programs. To this end, the committee
urges two compelling first steps. First, require that all children who are
referred to a protective services agency for evaluation of suspected abuse or
neglect be automatically referred for a developmental-behavioral screening
under Part C of the Individuals With Disabilities Education Act. Second,
establish explicit and effective linkages among agencies that currently are

EXECUTIVE SUMMARY 13
charged with implementing the work requirements of welfare reform and
those that oversee the provision of both early intervention programs and
child and adult mental health services.
â¢ Recommendation 11 â A comprehensive analysis of the profes-
sional development challenges facing the early childhood field should be
conducted as a collaborative effort involving professional organizations
and representatives from the wide array of training institutions that prepare
people to work with young children and their families. The responsibility
for convening such a broad-based working group or commission should be
shared among the fields of education, health, and human services.
RESEARCH AND EVALUATION
Research has historically played a significant role in enhancing human
development and preventing, ameliorating, and treating a range of condi-
tions that can begin prenatally, at birth, or during the early years of life. To
identify priorities among the many possible recommendations that could be
made for promising further research, the committee was guided by three
goals.
First, it is clear that the capacity to increase the odds of favorable birth
outcomes and positive adaptation in the early childhood years would be
strengthened considerably by supporting creative collaborations among
child development researchers, neuroscientists, and molecular geneticists.
Second, there is a pressing need to integrate basic research aimed at under-
standing developmental processes with intervention research that assesses
efforts to influence developmental outcomes. Such collaborative initiatives
hold the promise of advancing both understanding of environmental effects
on development and improving the effectiveness of the nationâs early inter-
vention strategies. Third, the entire early childhood evaluation enterprise
warrants a thorough reassessment in order to maximize opportunities for
valid causal inference and generalization, to assess what has been learned
cumulatively across the full array of evaluation studies, and to establish a
constructive environment for discussion of ongoing research and its appli-
cation to policy. The themes and issues presented below are elaborated in
the committeeâs full complement of research priorities in the final report.
Integrating Child Development Research,
Neuroscience, and Molecular Genetics
Enormous potential exists at the intersection of child development
research, neuroscience, and molecular and behavioral genetics to unlock
some of the enduring mysteries about how biogenetic and environmental
factors interact to influence developmental pathways. These include: (a)

14 FROM NEURONS TO NEIGHBORHOODS
understanding how experience is incorporated into the developing nervous
system and how the boundaries are determined that differentiate depriva-
tion from sufficiency and sufficiency from enrichment; (b) understanding
how biological processes, including neurochemical and neuroendocrine
factors, interact with environmental influences to affect the development
of complex behaviors, including self-regulatory capacities, prosocial or
antisocial tendencies, planning and sustained attention, and adaptive re-
sponses to stress; (c) describing the dynamics of gene-environment interac-
tions that underlie the development of behavior and contribute to differen-
tial susceptibility to risk and capacity for resilience; and (d) elucidating the
mechanisms that underlie nonoptimal birth outcomes and developmental
disabilities.
Integrating the Basic Science of Human Development and
the Applied Science of Early Childhood Intervention
There are currently few avenues for integrating knowledge gained from
basic developmental science and from evaluations of early interventions.
Yet both enterprises ultimately seek to improve childrenâs early outcomes
and life opportunities. A great deal stands to be gained from deliberate
efforts to forge ongoing interactions among scientists engaged in these
complementary yet largely disconnected research traditions. Among the
important objectives to be addressed are: (a) enhanced understanding, de-
tection, and treatment of early precursors of psychopathology; (b) improved
preventive and ameliorative interventions for women and children who are
exposed to biological insults and adverse environmental conditions, as well
as for children with identified disabilities; (c) the identification of modifi-
able mechanisms that link impoverished family resources to both adverse
outcomes for individual children and persistent disparities across groups of
children in learning skills and other developmental capacities; and (d) re-
fined understanding of how interventions and the staff that implement
them can work effectively with families that differ along dimensions de-
fined by race and ethnicity, immigration status, religion, or other cultural
characteristics. The capacity of research to address these objectives will
hinge in part on investments in improving the available tools for measuring
important, but generally neglected early developmental outcomes, such as
the multiple components of self-regulatory and executive capacities, and
the ability to make friends and engage with others as a contributing mem-
ber of a group, as well as on increased efforts to evaluate the biological
systems that are affected by early interventions.

EXECUTIVE SUMMARY 15
Improving Evaluations of Early Childhood Interventions
To improve the nationâs capacity to learn from evaluations of early
childhood interventions, the committee recommends substantially increased
attention to program implementation as an integral component of all early
childhood evaluation research, the adoption of higher standards for the use
of rigorous and appropriate evaluation study designs, the inclusion of early
childhood outcomes in evaluations of broad-based community and eco-
nomic interventions, and the convening of regular forums at the National
Institutes of Health to synthesize evaluation research evidence across pro-
grams and strategies that share similar developmental aims.
CONCLUDING THOUGHTS
As this report moved to completion, it became increasingly clear to the
members of the committee that the science of early childhood development
has often been viewed through highly personalized and sharply politicized
lenses. In many respects, this is an area in which personal experience allows
everyone to claim some level of expertise. Moreover, as a public issue,
questions about the care and protection of children confront many of the
basic values that have defined our country from its foundingâpersonal
responsibility, individual self-reliance, and restrained government involve-
ment in peopleâs lives. In a highly pluralistic society that is experiencing
dramatic economic and social change, however, the development of chil-
dren must be viewed as a matter of intense concern for both their parents
and for the nation as a whole.
In this context, and based on the evidence gleaned from a rich and
rapidly growing knowledge base, we feel an urgent need to call for a new
national dialogue focused on rethinking the meaning of both shared re-
sponsibility for children and strategic investment in their future. The time
has come to stop blaming parents, communities, business, and government,
and to shape a shared agenda to ensure both a rewarding childhood and a
promising future for all children.
The charge to this committee was to blend the knowledge and insights
of a broad range of disciplines to generate an integrated science of early
childhood development. The charge to society is to blend the skepticism of
a scientist, the passion of an advocate, the pragmatism of a policy maker,
the creativity of a practitioner, and the devotion of a parentâand to use
existing knowledge to ensure both a decent quality of life for all of our
children and a productive future for the nation.

How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media.

How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues.

The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more.

Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.

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